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General NPI Number Information
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NPI Number | 1902208507
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Entity Type | Organization
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Legal Business Name | PREMIER PHYSICAL THERAPY & ASSOCIATES INC
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 6591 COLLINS DR STE E8
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City | MOORPARK
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State | CA
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Zip | 93021-1492
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Country | US
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Telephone | 805-517-0151
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Fax | 805-517-0231
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Provider Business Mailing Address
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Address Line | 1160 N VENTURA RD
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City | OXNARD
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State | CA
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Zip | 93030-3802
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Country | US
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Telephone | 805-566-0600
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM BRYAN FISHER
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Credential |
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Telephone | 805-566-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 20274
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License Number State | CA
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